Individual
MRS. ABIGAIL RAE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LADC
Contact information
Practice address
207 JEFFERSON BLVD, BIG LAKE, MN 55309-4667
(763) 367-6080
Mailing address
207 JEFFERSON BLVD, BIG LAKE, MN 55309-4667
(763) 367-6080
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305134
MN
Other
Enumeration date
06/18/2018
Last updated
04/19/2024
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